Photodynamic Therapy (PDT)

The agent used in this treatment is highly selective for cancerous and precancerous cells. The risk of scarring or pigmentation changes in the skin are extremely low as healthy tissue and cells are not affected.

It is not used if you are pregnant or breast feeding.

The key benefits of PDT are:

• It is highly effective in removing precancerous skin lesions which will help reduce the risk of future skin cancer development
• Minimal downtime
• Ability to treat large areas at a time
• Can provide excellent cosmetic results
• Improvement in the signs of skin aging.

At Complete Skin Specialists we have a number of modified versions of this treatment to maximise your results.

We will choose a treatment protocol which will take into account:

• What we are trying to treat (skin cancer vs sun damage)
• The size of the area to be treated
• Location (face, hands, chest)
• Number of skin problems (pigmentation, capillaries etc)

With photodynamic therapy, one or more lesions can be treated at the same time. In most cases, the treatment protocol consists of 3 steps:

• Lesion preparation: to better assist absorption of the active chemical, the surface of the lesion is gently scraped to remove dead skin, crust or similar.
• Cream application: The photoactive cream is applied to the lesion and surrounding skin.
• Light source exposure: Red light PDT, Daylight PDT and Laser Enhanced PDT.

Red light PDT:
This is generally used for smaller areas and skin cancers.

The cream is applied under a dressing. This needs to be left on for 3 hours to allow the cream to absorb properly. During this time you are free to go home or leave our rooms and return.

After the 3 hrs we remove the dressing and shine the red light over the treatment area for 7 minutes. Local anaesthetic injections are sometimes used prior to the red light to help with discomfort.

For skin cancers, a second cycle of treatment is routinely repeated 2-4 weeks later.

Daylight PDT:
This is a newer application for PDT, specifically for the treatment of extensive sun damage (field therapy). It can be used for large areas such as the face, scalp,

You will be supplied with some creams to use in the 2 weeks leading up to treatment to prepare the skin.

Your skin will be prepared with a cleansing regime that allows for better penetration of the medication.

A sunscreen of SPF 30 will be applied to the face followed by light activated cream which will then be applied to the area being treated and left in place for 30 minutes.

You then sit outside in the daylight for 2 hours.

The cream is then washed off and sunscreen applied. Sun protection is very important for the next 48 hours.

Treatment is effective in both sunny weather and cloudy weather, all we require is daylight. It cannot be done on a rainy day.

The red and blue wavelengths in daylight activates the chemical just as the red light does, but the activation is much more gentle over a longer period of time and is virtually pain free.

The end reaction is like a moderate sunburn, peaking in severity 2-4 days after treatment, usually by the end of week one most of the peeling is complete.

Clearance of 70-80% of sunspots can be expected. This treatment is an excellent option for patients who do not want to use other topical agents including liquid nitrogen cryotherapy, and other topical treatments that are currently available.

Laser Assisted PDT:
We are able to improve your results by combining PDT with either our fractional CO2 laser or VBEAM (pulsed dye) laser.

The CO2 laser is used to create tiny channels in skin which is thicker such as the back or the hand or scalp. This improves the penetration of the light activated cream to enhance it’s effectiveness.

We can also combine it with our VBEAM laser to treat capillaries and redness in one session, which may give you a better overall cosmetic result.

Following PDT, the treated areas will appear quite red with peeling for up to one week. Temporary swelling around the lips and eyes can occur for a few days. You may also notice that any brown spots temporarily darken, and then peel off leaving normal skin behind (this may take up to 10 days to occur).

This is considered a normal and desirable reaction to achieve clearance of these lesions.

Improvement in the skin can continue for up to 3 months following treatment.

The results are variable, and depend on the degree of damage your skin has endured over the years.  However, most patients are happy with the results after just one treatment.

Expected improvements include:

• Significant clearance (70-80%) of actinic keratoses (rough dry red scaly skin patches)
• Improved smoothness of the skin
• Improvement in mottled brown pigmentation
• Fine wrinkles and some redness.

PDT does not improve:

• Coarse/deep wrinkles
• Capillaries (telangiectasia)
• Flushing
• Enlarged oil glands
• Seborrhoeic keratoses (warty lesions).

Typically you will only require one or two treatment sessions.  However, depending on the degree of your sun damage may suggest that you have the treatment done on a every one to two years. No one treatment can clear sun damage completely and permanently. Unfortunately we also accumulate more over time requiring maintenance.